Presurgical Invasive Study in Intractable Epilepsy: Intracranial Electrode and Brain Mapping

ABSTRACT

Improved diagnostic tools, patient selections, and operative techniques have brought a resurgence of the surgical management of intractable epilepsy recently. And the most remarkable developments of epilepsy surgery are various kinds of intensive presurgical evaluation. The aims of presurgical evaluation for intractable epilepsy are 1) The diagnosis of exact types of epilepsy for appropriate medical treatment as well as for surgical intervention. 2) The exact localization of epileptogenic region responsible for the patient's habitual seizures and testing for functional safety of the focal resection of epileptogenic region. Theoretically the presurgical evaluations can be classified as noninvasive and invasive studies. The noninvasive presurgical studies include various kinds of EEG investigations, neuroimaging, neuropsychological studies and other laboratory studies. The invasive presurgical evaluations include various kinds of intracranial electrode recording and functional brain mapping, The authors analysed the invasive presurgical evaluation of Yonsei epilepsy program since Oct. 1989 and review the literatures.